Outcomes of Gastrointestinal Polyps Resected Using Underwater Endoscopic Mucosal Resection (UEMR) Compared to Conventional Endoscopic Mucosal Resection (CEMR)
| Autor: | Vikas Chitnavis, Lindsey A. Bierle, Adil Mir, Shravani Reddy, Chirstopher Walsh, Mohammad Shakhatreh, Mohamad Mouchli, Paul Yeaton |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
recurrence medicine.medical_treatment Endoscopic mucosal resection 030204 cardiovascular system & hematology Lower risk piecemeal Resection conventional endoscopic mucosal resection (cemr) 03 medical and health sciences 0302 clinical medicine underwater endoscopic mucosal resection (uemr) medicine otorhinolaryngologic diseases Gastrointestinal Polyp medicine.diagnostic_test business.industry polypectomy General Engineering Gastroenterology medicine.disease Polypectomy digestive system diseases Colon polyps Surgery Endoscopy Dysplasia business 030217 neurology & neurosurgery |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| Popis: | Objective Underwater endoscopic mucosal resection (UEMR) is reported to be superior to conventional endoscopic mucosal resection (CMER) for the complete resection of large polyps and may offer increased procedural efficiency. Aims To compare recurrence rates and adverse events between UEMR and CEMR and define risk factors related to recurrence. Also, to assess recurrence rates in piecemeal endoscopic mucosal resection (EMR) based on the number of pieces resected. Methods We identified all patients with large polyps treated using the UEMR technique at Carilion Clinic, Roanoke, VA, USA between January 1, 2014 and December 31, 2017 with follow-up through October of 2018. We matched the UEMR patients with patients treated using the CEMR technique (1:2 matching, respectively). The Kaplan-Meier curve was used to estimate the cumulative risks of polyp recurrence. The Cox proportional hazard analysis was used to assess risk factors for developing polyp recurrence. Results Sixty-eight patients (mean age: 63.4 ± 12.5 years; 52.9% males) with polyps removed using the UEMR technique (Group 1) were matched with 122 patients (mean age: 64.4 ± 10.0 years; 51.6% males) who had polyps removed using CEMR (Group 2). Polyps resected in fewer pieces (≤ 3) had lower recurrence rates compared to the ones resected in >3 pieces. Right colon polyps removed using UEMR had a lower recurrence rate compared to right colon polyps resected using CEMR. Polyp size and a high degree of dysplasia were associated with a high risk of polyp recurrence after resection. Completing advanced endoscopy training was also associated with a lower risk of recurrence. Conclusion UEMR had a lower recurrence rate compared with CEMR for right colon polyps. Factors associated with recurrence included the degree of training, high-grade dysplasia, and polyp size. |
| Databáze: | OpenAIRE |
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